Tremfya Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Tremfya Injection contains guselkumab, a monoclonal antibody that belongs to the interleukin-23 (IL-23) inhibitor class of biologic medicines. It is used to treat moderate to severe plaque psoriasis, active psoriatic arthritis, moderately to severely active ulcerative colitis, and moderately to severely active Crohn's disease. It works by blocking IL-23, a protein involved in inflammation, helping to reduce symptoms in the skin, joints, and gut. It is given as an injection under the skin, with some induction doses for bowel conditions possibly given by infusion.

What is Tremfya Injection

Tremfya contains guselkumab, a lab-made protein called a monoclonal antibody. It belongs to a group of biologic medicines. It works by blocking a protein in the body involved in inflammation, which helps reduce symptoms of certain inflammatory conditions affecting the skin, joints, and gut.

Tremfya Injection uses

• Moderate to severe plaque psoriasis in adults and children 6 years of age and older who weigh at least 40 kg and are candidates for systemic therapy or phototherapy
• Active psoriatic arthritis in adults and children 6 years of age and older who weigh at least 40 kg
• Moderately to severely active ulcerative colitis in adults
• Moderately to severely active Crohn's disease in adults

Benefits of Tremfya Injection

• Can improve the condition of the skin and appearance of nails in plaque psoriasis, reducing scaling, shedding, flaking, itching, pain and burning
• In psoriatic arthritis, can reduce signs and symptoms, slow damage to cartilage and bone of the joints, and improve ability to do normal daily activities
• In ulcerative colitis, can reduce bloody stools, urgency and frequency of toilet visits, abdominal pain, and inflammation of the intestinal lining, improving daily activities and reducing fatigue
• In Crohn's disease, can reduce diarrhea, abdominal pain, and inflammation of the intestinal lining, improving daily activities and reducing fatigue

How Tremfya Injection works

Tremfya works by blocking a protein called IL-23 that plays a role in inflammatory and immune responses. By stopping IL-23 from attaching to its receptor, the medicine reduces the signals that cause inflammation in the skin, joints, and gut.

Tremfya Injection dosage

Tremfya is given as an injection under the skin (subcutaneous injection). Adults may self-inject using a pre-filled pen, pre-filled syringe, or One-Press injector after proper training. Children should not self-inject; a doctor, nurse, or trained caregiver should give the injection.

For ulcerative colitis or Crohn's disease, the starting (induction) doses may be given either as an infusion into a vein by a healthcare professional or as injections under the skin; maintenance doses are given under the skin afterward.

Take the medicine out of the refrigerator and let it sit at room temperature for about 30 minutes before injecting; do not warm it any other way. Do not shake the medicine. Avoid injecting into skin that is tender, bruised, red, scaly, hard, thick, has scars, or is affected by psoriasis; where possible avoid areas of skin affected by psoriasis as injection sites.

If a dose is missed, it should be given as soon as possible, then dosing resumes at the regular schedule.

Available forms and strengths

Injection

Side effects of Tremfya Injection

Common

• Respiratory tract infections
• Headache
• Joint pain (arthralgia)
• Diarrhoea
• Increased level of liver enzymes in the blood
• Skin rash
• Redness, irritation or pain at the injection site
• Fatigue
• Fever
• Abdominal pain

Serious

• Serious allergic reaction (anaphylaxis) with symptoms such as difficulty breathing or swallowing, swelling of the face, lips, tongue or throat, severe itching with red rash or raised bumps, lightheadedness or dizziness
• Serious or clinically important infections, including tuberculosis
• Decreased number of a type of white blood cell called neutrophils
• Liver problems including drug-induced liver injury

Warnings and precautions

• Do not use this medicine if you have a serious active infection, including active tuberculosis.
• This medicine may increase the risk of infections; treatment should not start until an active infection has resolved or is adequately treated.
• Patients should be checked for tuberculosis before starting treatment and monitored for signs of active TB during and after treatment.
• Serious allergic reactions, including anaphylaxis, have occurred, sometimes several days after treatment.
• Liver enzyme elevations can occur, especially with more frequent dosing in psoriatic arthritis; liver function should be monitored.
• Live vaccines should not be given while using this medicine; vaccinations should be brought up to date before starting treatment.
• This medicine contains polysorbate 80, which may cause allergic reactions.
• This medicine should not be used in pregnancy as its effects on pregnant women are not known. Women who could become pregnant should use effective contraception during treatment and for at least 12 weeks after the last dose.
• It is not known if this medicine passes into breast milk. Talk to your doctor about whether to breastfeed or use this medicine.
• This medicine has not been specifically studied in people with kidney problems, but no dose adjustment is expected to be needed.
• This medicine has not been specifically studied in people with liver problems; no dose adjustment is expected to be needed, but your doctor may check your liver function with blood tests before and during treatment.
• There is no known direct interaction between this medicine and alcohol, but drinking alcohol may affect your underlying condition and your immune system, so discuss your alcohol use with your doctor.
• This medicine is not expected to affect your ability to drive or use machines.

Storage

• Store in a refrigerator (2°C–8°C / 36°F to 46°F). Do not freeze.
• Keep the pre-filled pen, syringe, or vial in the outer carton in order to protect from light.
• Do not shake.
• Do not use if the solution is cloudy or discoloured, or contains large particles.
• This medicine is for single use only; dispose of any unused portion.
• Dispose of used sharps (pens/syringes) in a proper sharps disposal container, not in household waste.

When to see a doctor

• Stop using this medicine and get emergency medical help immediately if you have signs of a serious allergic reaction, such as difficulty breathing or swallowing, swelling of the face, lips, tongue or throat, severe itching with rash or raised bumps, or dizziness/fainting.
• Seek medical advice promptly if you notice signs of infection, such as fever, chills, muscle aches, cough, shortness of breath, blood in phlegm, weight loss, diarrhoea or stomach pain, or warm, red, or painful skin sores different from your usual psoriasis.
• Seek medical attention if you notice signs of liver problems such as unexplained rash, nausea, vomiting, stomach pain, tiredness, loss of appetite, yellowing of the skin or eyes, or dark urine.

Alternatives

• Skyrizi
• Taltz
• Cosentyx